LO-II: Child growth and Development

 Learning outcomes at the end of the chapter,

the trainees be able to:
Define growth and development
Describe the principles of development
Describe development stages and theories
 Introduction

 We often people refer to children’s growth and

development. Are ‘growth’ and ’development’ the
same thing?
 Growth refers to specific body changes and increases
in the child’s size (such as height, weight, head
circumference, and body mass index).
 The term growth denotes a net increase in the size, or
mass of the tissue. It is largely attributed to
multiplication of cells and increase in the intracellular
substance
 Introduction…

 Development’ typically refers to an increase

complexity of (a change from simple to more
complex activity)
 Development refers to a process of change in growth
and capability over time, as function of both
maturation and interaction with the environment
 Introduction…

 Development involves a progression along a

continuing pathway on which the child acquires more
refined knowledge, behavior and skills. The sequence
is basically the same for all children; however, the
rate varies
 Principles of child development

Principle 1: Development involves change

Principle-2: Early development is more critical than
later development
Principle-3: Development is the product of maturation
and learning
Principle-4: The development pattern is
predictable
• Cephalocaudal law:
Development spreads over
the body from head to foot
• Proximodistal law:
From the central axis of
the body toward the
extremities
 Principle-5: The developmental pattern has
predictable characteristics
 Similarity in developmental patterns
 Development proceeds from general to specific
responses
 Principle -5…

 Development is continuous

 Different areas develop at different rates

 There is correlation in development
 Principle-6: There are individual differences in
development
Different expectations
Basis of individuality
Child-rearing must be individualized
Prediction is difficult
 Other principles…

 Principle-7: There are periods in the development

pattern
 Principle-8: There are social expectations for every
developmental period
 Principle-9: Every area of development has hazards
 Principle-10: Happiness varies at different periods in
development
 Summary

 What is the practical significance of the ten principles

of development?
 2. Child Developmental theories
Introduction
 The diversity of theories makes understanding
children’s development a challenging undertaking
 Child development is a complex, multifaceted topic
 No single theory has been able to account for all
aspects of child development
 Theories of child development

 Psychoanalytic theories
 Cognitive theories
 Behavioural and social cognitive theories
 Ethological theories
 Ecological theories
 An eclectic theoretical orientation
 A. Psychoanalytic theories
 Believe that behavior is merely a surface
characteristic
 A true understanding of development requires
analyzing the symbolic meanings of behavior and
deep inner workings of the mind
 They also stress that early experiences with parents
extensively shape development
 Freud’s Psychosexual theory

 The primary source of psychic energy, is sexual

 Three personality structures the ‘id’, ’ego’ and
‘superego’
 Freud’s Stages of development

 There are five Freudian psychosexual stages: oral,

anal, phallic, latency, and genital
 According to Freud, Our adult personality is
determined by the way we resolve conflicts between
these early sources of pleasure
 If the need for pleasure at any stage is either under
gratified or over gratified, an individual may become
fixated, or locked in, at that stage of development
 Psychosexual developmental stage
Stages of development Age ranges Activity
Oral 0-2yrs Body satisfaction come through the
mouth
Anal 2-3yrs ‘Mud pie period‘, Sublimation
Phallic 3-6yrs Oedipus complex & Electra complex
Latency 6-10yrs Involve with learning, developing
cognitive skills, and actively
participating in sports activities
The child’s main relationships are
with peers of the same sex
Genital 11-13yrs Physical puberty & social puberty
occurs
Self-healing process
 Erikson's Psychosocial theory

 Believed that child development is through

psychosocial stages, rather than in psychosexual
stages
 The primary motivation was social and reflected a
desire to affiliate with other people
 Developmental change throughout the human life
span
 Cognitive developmental theory

 Psychoanalytic theories stress the importance

of children’s unconscious thoughts, whereas
cognitive theories emphasize their conscious
thoughts
Three important cognitive theories are Piaget’s
cognitive development theory, Vygotsky’s
sociocultural cognitive theory, and information
processing theory
 Piaget’s Cognitive Development Theory
 Four stages of cognitive development; sensoriomotor
stage, preoperational stage, concrete operational
stage, and formal operational stage
Two processes underlie this cognitive
construction of the world: organization and
adaptation.
Piaget believed that we adapt in two ways:
assimilation and accommodation.
 The Sensorimotor Stage(0-2yrs)

 Infants construct an understanding of the world by

coordinating sensory experiences (seeing, hearing)
with motor actions (reaching, touching)
 Develop Object Permanence (memory)
 Infants progress from reflexive, instinctual actions at
birth to the beginning of problem solving(intellectual)
and symbolic abilities (language) toward the end of
this stage
 Preoperational Stage (2-7yrs)

 This stage begins when

the child starts to use
symbols and language
 Preconceptual stage(2-4
yrs)
 Intuitive stage (4-7yrs)
 Key features of the stages
 Egocentrism: ‘if i can't see
you, you also can't see me’
 Animism: Treating
inanimate objects as living
ones
 Concentration:
concentrating on one
limited aspect of a
stimulus and ignoring
other aspects
Concrete Operational Stage (7-12yrs)
 Characterized by the
appropriate use of logic
 Seriation
 Transitivity
 Classification
 Decentring
 Reversibility
 Conservation
 Elimination of Egocentrism
 Performs operations
Formal Operational Stage(12yrs & above)

 The ability to systematically solve a problem in a

logical and methodological way
 Develops skills such as logical thought, deductive
reasoning as well as inductive reasoning and
systematic planning etc.
 Understands that nothing is absolute; everything is
relative
 Understands that the rules of any game or social
system are developed by a man by mutual agreement
and hence could be changed or modified.
Stages of Piaget cognitive theory
 Lev vygotsky sociocultural development

 Emphasizes how culture and social interaction guide

cognitive development
 Portrayed the child’s development as inseparable
from social and cultural activities
 ‘Through others, we become ourselves’
 Zone of Proximal Development
A child develops in the context of a culture
Any question? Suggestion?
 The domains of child development
 Developmental milestones are a set of functional
skills or age specific tasks that most children can at a
certain age range
 It Includes
Gross motor
Vision and fine motor
Hearing, speech and language
Social, emotional and behavioral
 Gross motor function

 Gross motor skill is the functional ability

(coordination movement) that needs extra extremity
or group of muscle
It includes
Walking
Jumping
Sitting up
Rolling
Balancing
 Fine motor
 Fine motor skills includes
Grasping
Building block
Holding pen b/n thumb and index finger
Counting the book page
Folding paper into different shape
Using crayons
 The growth and development of
infant:28months to 1year
 Physical Development
Head and Skull
Head Circumference
 At birth, an infant’s head circumference averages
about 13.75 inches (35 cm) and is usually slightly
larger than the chest circumference
 The chest measures about the same as the abdomen at
birth. At about 1 year of age, the head circumference
has grown to about 18 inches (47 cm)
Physical development
 Physical…
Fontanels and Cranial Sutures
 The posterior fontanel is usually closed by the 2nd or
3rd month of life
 The anterior fontanel may increase slightly in size
during the first few months of life
 After the 6th month it begins to decrease in size,
closing between the 12th and the 18th months. The
sutures between the cranial bones do not ossify until
later childhood
 Physical …

 Eruption of Deciduous Teeth

 Psychosocial Development

 Caregivers who expect too much too soon from the

infant are not encouraging optimal development
 Rather than teaching the rules of life before the infant
has learned to trust the environment, the caregivers are
actually teaching that nothing is gained by one’s own
activity and that the world does not respond to one’s
needs
Age Physical Personal- Fine motor Gross motor Language Cognition
social

28 Lower Imitates Holds cup Reaches Babbling -

wks incisors simple Transfers without decreases
followed acts Objects visual Duplicates
by upper Responds from One guidance “ma-ma”
central to “no” hand to the Can lift head and “pa-
incisors Shows other up when in a pa”
preferenc supine sounds
es position
and
dislikes
for food
Age Physical Personal- Fine motor Gross Language Cognition
social motor

40wk Birth weight Does things Holds tools Stands Words Coordinati
s-1yr tripled; has six to with one alone; emerge on
teeth; Babinski attract hand begins to Says “da- of
reflex disappears attention and works walk da” and secondary
Anterior fontanel Tries to on it with alone “ma-ma” schemes;
closes between follow another Can change with masters
now and when being Puts toy in self meaning barrier
18 mon read to box after from prone to reach
Imitates demonstrati to goal,
parents on sitting to symbolic
Looks for Starts blocks standing meanings
objects not holds crayon position
in sight to
scribble on
paper
Growth and Development of the Toddler: 1
to 3 Years
 Physical Development
 Toddlerhood is a time of slowed growth and rapid
development
 Each year the toddler gains 2.26 to 4.53 kg and about
7.62 cm
 Continued eruption of teeth, particularly the molars,
helps the toddler learn to chew food
 Most children say their first words and continue to
improve and refine their language skills
 Psychosocial Development

 Behavioral Characteristics
 Negativism, ritualism, dawdling, and temper tantrums
are characteristic behaviors seen in toddlers
Ag Personal-social Fine motor Gross motor Language Cognition
e
24 Language Turns pages of a Runs well Begins to use Enters
mo facilitates book singly with little words to preconceptua
autonomy Adept at building falling explain past l
Sense of a tower of Throws and events or to phase of
power six or seven cubes kicks a ball discuss cognitive
from saying When drawing, Walks up objects not development
“no” and attempts to and down observably State of
“mine” enclose a space stairs one present continuous
Increased step at a Rapidly investigations
independence time expands Primary focus
from vocabulary to is egocentric
mother about 300
words; uses
plurals
Age(m Personal- Fine motor Gross motor Language Cognition
onth) social

36 Basic concepts Copies a circle Balances on Quest for Preconcept

of sexuality are and a straight one foot; information ual phase
established line jumps in furthered by continues;
Separates from Grasps spoon place; questions can think of
mother more between pedals like “why,” only one
easily thumb and tricycles “when,” idea at a
Attends to index finger “where,” time;
toilet Holds cup by and “how” cannot
needs handle think of all
parts in
terms of the
whole
Growth and Development of the Preschool
Child: 3 to 6 Years
 Physical Development
 The physical development seen in the preschool child
includes a slowed growth rate, changes in dentition
and visual development, as well as skeletal growth
changes, especially in the feet and legs
 Cont’d
 The preschool period is one of slow growth
 gains about 1.4 - 2.3 kg each year and grows 6.3 cm
Age(yr) Personal-social Fine motor Gross motor Language Cognition
3 Begins Erikson’s Able to Tends to Vocabulary Continues
stage of button watch up to in
“initiative vs. clothes motor 1,000 words preoperatio
guilt”; Copies and activities Articulates nal state
conscience Uses pencils, before vowels (2–7 years)
develops; crayons, attempting accurately characterize
shy with paints them Talks a lot d by:
strangers and Shows Can jump Sings and Centration,
inept with peers preference several feet recites or
Sufficiently for right or Uses hands Asks many Egocentric,
independent left hand in broad questions or
to be interested movements irreversible
in group Rides
experiences tricycle
with age mates Negotiates
(e.g., nursery stairs
school well
Growth and Development of the School-
Age Child:6 to 10 Years
 Physical Development
 The physical development of the school-age child
includes changes in weight and height, as well as
changes in dentition and the eruption of permanent
teeth
 Between the ages of 6 - 10yrs, growth is slow and
steady
 Average annual weight gain is about 2 to 3 kg By age
7, the child weighs about seven times as much as at
birth
 Annual height increase is about 6 cm This period
ends in the preadolescent growth spurt in girls at
about age 10 and in boys at about age 12
Age Physical Motor Personal – Languag Perceptu Cognition
social e al

7 Weight is More More Can name b, p, d, q Begins to

seven cautious cooperative day, confusion use simple
times birth Swims Same-sex month, resolved logic
weight Printing play season Can copy Can group
Gains 2–3 smaller group and Produces a in ascending
kg than 6- friends all diamond order
Grows yearold’s Less language Grasps basic
5–6 cm Activity egocentric sounds idea of
level addition and
lower than subtraction
6yrs Conservatio
n of
substance
Can tell time
 Developmental Delay

A significant delay (more than two standard

deviations below the mean) in one or more of
the following developmental domains:
 Gross motor
 Vision & Fine motor
 Hearing, Speech & Language
 Social, Emotional & Behavioral

Walters, 2010
 Developmental delay

Developmental delay is a descriptive term used for

children whose difficulties are apparent earlier in
childhood where a cause is not yet established. It
does not imply a particular organic or syndromic
cause.

Walters, 2010
 Types

Global Developmental Delay Specific Developmental delay

 Delay in two or more  Delay in a single
domains (often delayed domain (e.g. Motor or
in all domains) Speech & Language)
 Developmental Delay

Transient Persistent
 Some extremely  Problems in one or
premature babies more
 Physical illness and of the following areas:
prolonged Understanding and
hospitalization, learning
immaturity, family Moving
stress or lack of Communication
opportunities to learn Hearing
seeing
 Causes
 Genetic (e.g., chromosomal abnormalities)
 Pregnancy & birth factors (e.g., prematurity)
 Infancy & childhood: illness, poisoning, brain
injury, etc
 Environmental factors: lack of stimulation
 Unknown (in most cases)
Graphic presentation of developmental
delay
Growth and development graph
 Developmental “Red flags”

 No visual following by 8 weeks and poor eye contact

 Uncoordinated eye movements with head turning
after 3 months
 Persistent fisting (especially with thumbs adducted
across the palms beyond 3 months)
 Developmental “Red flags”

 No head control by 6 months

 No sitting independently by 10 months
 Unable to walk alone at 18 months
 No pointing to show demand or interest by 14 months
 No words with meaning by 18 months
 No joining two words by 30 months
 Features of pervasive developmental
disorders
 Compulsive & ritualistic activities
 Severe language delay
 Poorly developed social relationship
 Abnormal attachment to inanimate objects
 Inappropriate affect & tantrums
 Early Identification of Developmental
Delay

 Only about 50% of developmental problems detected

before the children begin school
 Parents are the 1st to pick up the signs
 Use a range of methods to evaluate children’s
development
 Checklist of developmental milestones
 Clinical judgment
 Parental recall of milestones
 Parent report of current achievements
 Developmental screening tests
 Developmental surveillance
 Parent evaluation of developmental status (1st line screen)

(Australian Family Physician Vol. 34, No. 9, September 2005)

[Link]/professionals/practice/[Link]
 The routines-based early intervention
(RBEI) program
The RBEI program focuses on achieving
functional outcomes, namely child’s
independence, social relationships with others, and
parents’ satisfaction with routines, by providing
the children with learning opportunities in
naturally occurring contexts (i.e., daily routines)
and systematically uses collaboration and
coaching to set functional goals and implement
service plans with the family
 summary

 Developmental delays are common, and can involve

different domains of a child’s functioning
 A combination of methods is required to detect cases
of developmental delay
 Early intervention provides the best opportunity for
positive outcomes for the child and the family .